• Welcome to OGBoards 10.0, keep in mind that we will be making LOTS of changes to smooth out the experience here and make it as close as possible functionally to the old software, but feel free to drop suggestions or requests in the Tech Support subforum!

ACA Running Thread

Deacon923 said:
Just playing devil's advocate here - if people had no health insurance or insurance so crappy that it didn't actually do anything for them, they would be unlikely to access preventive care or be able to manage chronic conditions. This would result in higher spending on emergency room visits and procedures to deal with the fallout when their unmanaged conditions reach crisis. So, isn't it possible that forcing these people to get better insurance (supported by subsidies) would, over time, reduce per capita health care spending since an ounce of prevention and diabetes management is worth a pound of ER visits and foot amputations?
Click to expand...

I think this is a good point, but worth realizing it only applies to a fraction of people who are losing their existing coverage. The "it was crappy insurance anyways" refrain doesn't apply when folks are paying for coverage they will never need. Maternity care for people that are past childbearing age, for example.
 
ibleedgoldandblack said:
So once we force them to have the coverage, are we also going to force them to go get the checkups and other preventative care that is covered? If they refuse are we going to tax/penalize them further?
Click to expand...

I think the large majority of people would prefer to be able to buy insulin and treat their diabetes instead of going blind and having their feet cut off. There are always going to be some people who cannot or will not manage their conditions but most people want to access preventive care.
 
Deacon923 said:
Just playing devil's advocate here - if people had no health insurance or insurance so crappy that it didn't actually do anything for them, they would be unlikely to access preventive care or be able to manage chronic conditions. This would result in higher spending on emergency room visits and procedures to deal with the fallout when their unmanaged conditions reach crisis. So, isn't it possible that forcing these people to get better insurance (supported by subsidies) would, over time, reduce per capita health care spending since an ounce of prevention and diabetes management is worth a pound of ER visits and foot amputations?
Click to expand...

Fair question. The majority of the policies that were cancelled weren't crappy at all. That's a myth. Most covered preventive at 100% at no cost per the ACA. They just aren't rich plans. Putting people into plans richer than they need will drive trend for everyone. Id argue with anyone on this point. We routinely see richer plans have much higher MLRs.

I think we also need to dispel the myth that someone cant pay for preventive care (or even sick care) out of pocket without insurance. We can discuss whether getting free preventive is good or not (nothing is free here) but getting a physical isn't expensive and doesn't require insurance. Going to the doc vs. the ER when you have the flu and are uninsured isn't hard. Its especially not hard for someone not eligible for a subsidy.

I certainly understand challenges of low income people in accessing care. I'm not dismissing those at all. But the average middle class american should have no issues with paying or an annual physical or getting a flu shot IMHO.
 
RJKarl said:
For the first three years, the states wouldn't be picking up a penny of the expansion either. With just marginal economic growth during the next three years, almost all of those covered in the expansion would have employer or other coverage due having a lower unemployment rate.

States would also be saving billions in having to cover costs who don't have insurance and would be covered for their ER and other needs.
Click to expand...

yeah, because as we know, medical trend is outpaced by economic growth. Listen, i think we should have expanded medicaid. i cant tell you how many sub 100% FPL people I've spoken to that aren't subsidy eligible. That sucks. But to dismiss the economics of what medicaid might cost a state is not accurate. Granted, its a 90% discount but the 10% is very real.
 
CHDeac said:
Fair question. The majority of the policies that were cancelled weren't crappy at all. That's a myth. Most covered preventive at 100% at no cost per the ACA. They just aren't rich plans. Putting people into plans richer than they need will drive trend for everyone. Id argue with anyone on this point. We routinely see richer plans have much higher MLRs.

I think we also need to dispel the myth that someone cant pay for preventive care (or even sick care) out of pocket without insurance. We can discuss whether getting free preventive is good or not (nothing is free here) but getting a physical isn't expensive and doesn't require insurance. Going to the doc vs. the ER when you have the flu and are uninsured isn't hard. Its especially not hard for someone not eligible for a subsidy.

I certainly understand challenges of low income people in accessing care. I'm not dismissing those at all. But the average middle class american should have no issues with paying or an annual physical or getting a flu shot IMHO.
Click to expand...

And more paying out of pocket would go a very long way to fixing over pricing. Could you imagine how much a loaf of bread would cost if your employer took bread money out of your check, paid a bread making management group who in turn paid a bread making distribution group who in turn paid bread makers?
 
I wonder if we are reaching the tipping point, where the GOP will finally accept the reality that the ACA is never going anywhere, and start working on conservative solutions to shore it up. The Dems are ready to deal--eager, not quite desperate, but close--and would likely give back quite a lot, provision by provision, to get some GOP co-signing on the concept of HC reform. The ACA needs tweaks and adjustments just like any large legislative regime, but the GOP still seems to think they can wish it all away. I really hope we're getting closer to horse-trading this thing into better shape, but I don't think we're there yet. Guys like Cruz continue to stand fully in the way of any kind of progress in government, and seem to think they are heroes for doing it.
 
ArlingtonDeac said:
I wonder if we are reaching the tipping point, where the GOP will finally accept the reality that the ACA is never going anywhere, and start working on conservative solutions to shore it up. The Dems are ready to deal--eager, not quite desperate, but close--and would likely give back quite a lot, provision by provision, to get some GOP co-signing on the concept of HC reform. The ACA needs tweaks and adjustments just like any large legislative regime, but the GOP still seems to think they can wish it all away. I really hope we're getting closer to horse-trading this thing into better shape, but I don't think we're there yet. Guys like Cruz continue to stand fully in the way of any kind of progress in government, and seem to think they are heroes for doing it.
Click to expand...

Unfortunately modern US politics is an us v them game. I don't see Pubs tethering themselves to a weight around their "opponents" leg that has the potential to drag them to the bottom of the sea...even if it drags the economy down with them. That being said, pinning all the blame of the Republicans is short sided IMO. The conception of this awful piece of legislation is at least part of the reason we are were we are and that falls squarely on the Dems in Congress and the President. Plenty of blame to go around on this one.
 
Would love to see that happen, Arlington. But it seems the GOP (or a goodly portion of it) has dug themselves so deeply into an entrenched opposition. And the "base" seems unable to consider anything other than that the ACA is a poorly veiled doomsday machine that could never be anything but. So it's hard for me to be very hopeful.

Yet I do hope our should-be leaders can come better together and make it (healthcare reform, etc.) work better.
 
ArlingtonDeac said:
I wonder if we are reaching the tipping point, where the GOP will finally accept the reality that the ACA is never going anywhere, and start working on conservative solutions to shore it up. The Dems are ready to deal--eager, not quite desperate, but close--and would likely give back quite a lot, provision by provision, to get some GOP co-signing on the concept of HC reform. The ACA needs tweaks and adjustments just like any large legislative regime, but the GOP still seems to think they can wish it all away. I really hope we're getting closer to horse-trading this thing into better shape, but I don't think we're there yet. Guys like Cruz continue to stand fully in the way of any kind of progress in government, and seem to think they are heroes for doing it.
Click to expand...

Why would the GOP do that? It would amount to riding to the rescue of the Democrats. There is a reason that the Dems are "eager" and there is a reason why they'll be "desperate soon enough." From a political standpoint, they should let the Dems sink with this millstone they tied around their neck. Once it does all the damage to the Democratic party that it is going to do, the Pubs can make their hay and be seen as the ones that are fixing/cleaning up this mess.
 
Cruz is a hero to his constituents and a large portion of his base.
 
SkinsNDeacs said:
Unfortunately modern US politics is an us v them game. I don't see Pubs tethering themselves to a weight around their "opponents" leg that has the potential to drag them to the bottom of the sea...even if it drags the economy down with them. That being said, pinning all the blame of the Republicans is short sided IMO. The conception of this awful piece of legislation is at least part of the reason we are were we are and that falls squarely on the Dems in Congress and the President. Plenty of blame to go around on this one.
Click to expand...

Sorry, website stupidity aside, I won't buy into the scare tactics on the ACA. For all it warts, the country is much, much better off after its passage. It needs fine-tuning, which the GOP currently won't allow, but I'll take what we have now over what we had before, without a second thought. Its greatest accomplishment may be forcing the right to accept that serious HC reform is going to happen, no matter how much insurance-lobby money is poured into the opposition. For that alone, The ACA was a watershed accomplishment.

It was hard for the Dems to understand in 2009--hard for anyone, really--that the GOP would rather wreck the government and economy than accept a political loss on HC reform. The Dems vastly underestimated how deeply into the pockets of the insurance lobby the GOP had fallen. When the ACA passed, the natural assumption in Washington on the left was that further tweaks would be hammered about by grudging bipartisan agreement, as usually happens when a big legislative battle is fought and determined. Who'd have thought the GOP would instead spend the next 4-7 years intentionally trying to make the ACA not work as intended, at the detriment to health care systems, the economy, and even their own political positioning? But that's what special interest money does -- it places the desires of a specific group of corporate interests over the well-being of the nation. And that's what today's GOP does on most issues, in a nutshell. It's why we can't get anything done regarding HC reform, sensible gun laws, sensible environmental legislation, etc. If the money doesn't want it, the GOP won't allow it. Not even sensible inches, like, say, background checks.

If the GOP runs against Obamacare for the third straight election, they are going to slip even further down the crevasse. At some point, you have to stop touching the stove.
 
ibleedgoldandblack said:
Why would the GOP do that? It would amount to riding to the rescue of the Democrats. There is a reason that the Dems are "eager" and there is a reason why they'll be "desperate soon enough." From a political standpoint, they should let the Dems sink with this millstone they tied around their neck. Once it does all the damage to the Democratic party that it is going to do, the Pubs can make their hay and be seen as the ones that are fixing/cleaning up this mess.
Click to expand...

They could do it because, maybe, they want to govern rather than politic. It's funny how hard that concept is to even consider in todays' Washington.

The Dems don't need rescue, politically, on Obamacare. For all the heat they are getting for the website now, it'll fade in a few months when the kins get worked. HC reform is not, third time around, suddenly going to be a winning issue for the Pubs. By next fall I expect an entirely different public tenor regarding the cheap and wide availability of decent HC insurance. But the Dems didn't do themselves any favors by crapping out on this website launch.
 
You would be wrong (with all due respect) if you think the only pitfalls of the ACA are website glitches. Just wait until young healthy people don't sign up...this thing will crash under its own weight.
 
PhDeac said:
Cruz is a hero to his constituents and a large portion of his base.
Click to expand...

But he may not survive the fight inside the GOP. I wouldn't bet on him, in fact. I don't think Cruz can shake his ownership of the shutdown debacle, or the public perception that he's a poorly-strategizing ideologue. These Tea Party fanatics don't understand that the GOP machine, ultimately, has more power. The Tea Party can tip them in a few spots, steal a few primaries, make things hotter on a few key issues, etc. But they won't take the power away from the money, and the GOP money is moving back toward the moderates, IMO. Cruz seems like a guy who doesn't understand that "Tea Party" hero might feel great, but you're not getting a bigger job as a result. You've just maxed out. And you've maxed out on a movement that, IMO, is about to be shoved to the curb. The GOP money has seen enough. It didn't work, so it's time to go back to the adults.
 
SkinsNDeacs said:
You would be wrong (with all due respect) if you think the only pitfalls of the ACA are website glitches. Just wait until young healthy people don't sign up...this thing will crash under its own weight.
Click to expand...

I understand that that is the last stand of the GOP -- do everything possible to trick young people into foolishly avoiding having health insurance. It's a truly embarrassing/disgusting tactic to hurt the legislation, with only special-interest profit margins in mind. Honestly, it should make your skin crawl-- the GOP knows the system will likely work, unless they sabotage it, and so they intend to do just that. Now that's leadership! I just don't think it will work. For all the bustle, most people--yes, even young people--actually want to covered in case of catastrophic illness, and will take cheap insurance when provided. I think young people are smarter and more responsible than the GOP hopes/gives them credit for. This terrible GOP campaign against personal responsibility is just breathtaking in its hypocrisy, but ultimately futile, IMO.
 
Last edited:
I think you overestimate young people. I think they would rather take the cheaper option and take the tax...they aint thinking about "cheap" health insurance (no matter how bad that might be).
 
SkinsNDeacs said:
I think you overestimate young people. I think they would rather take the cheaper option and take the tax...they aint thinking about "cheap" health insurance (no matter how bad that might be).
Click to expand...

I think the GOP regularly and systematically underestimates them, and that's why the lose.

And GOP parents, though loudly rooting against this legislation, will be quietly signing their kids up for cheap insurance, or advising that they do so themselves. That's why this campaign will lose. It's illogical and anti-personal responsibility. Very few with any sense are going to turn down being covered for peanuts over not having a safety net at all, when it comes to their own personal needs.

You can only sell something ridiculous so much.
 
You must log in or register to reply here.
Back
Top